Partnership to Advance Tribal Health

Stratis Health has a longstanding commitment to improving care for American Indian and Alaska Native (AI/AN) people. While AI/AN populations commonly experience lower health statuses than other Americans, there are many customized services and supports that can improve health equity. When properly deployed, they lessen the high risk of health care inequities attributable to historical and ongoing structural and social drivers of health (e.g., high poverty rates, cultural and individual trauma, and geographical and environmental challenges).

The American Indian Alaska Native (AIAN) Healthcare Quality Improvement Program, funded by the Centers for Medicare & Medicaid Services (CMS), was a collaborative effort to improve health care for American Indians and Alaska Natives. Stratis Health, Comagine Health, and Mountain-Pacific Quality Health jointly led this work as the Partnership to Advance Tribal Health (PATH) from 2016 to 2024. They supported 24 Indian Health Services (IHS) managed hospitals nationwide. The goal was to improve health care quality and address the unique health care issues of the populations IHS hospitals serve by implementing best practices and providing performance improvement training and coaching.

Actions

Stratis Health staff served in national and local leadership roles and provided technical assistance in the areas of quality improvement, culture of safety, and health equity.

In addition to serving in leadership roles, Stratis Health staff provided analytic support for facility-level data and developed and facilitated national leadership learning circles and training sessions where IHS hospital staff learned and practiced leadership skills, shared experiences and promising practices, and built relationships with colleagues in other IHS facilities.
In Minnesota, Stratis Health staff worked with IHS to develop leaders, promote teamwork, provide training to foster a culture of improvement and patient safety, adopt and spread clinical best practices, and obtain and retain hospital accreditation and patient-centered medical home (PCMH) certification. Hospital-specific projects included:

• Cass Lake Indian Health Service (hospital, emergency department, clinic, dental, physical therapy) – Cass Lake, MN
  • Provided ongoing quality, safety, and team-based care training and technical assistance
  • Supported delivery of safe, culturally sensitive care
  • Collaborated with IHS, Tribal Health, Tribal Human Services, and other community partners to improve community health
• Red Lake Indian Health Service (hospital, emergency department, clinic, dental, behavioral health) – Red Lake, MN:
  • Provided ongoing coaching and assistance for facility quality and safety leaders
  • Provided ongoing quality, safety, and team-based care training and technical assistance for accreditation survey readiness and achievement of PCMH certification

Key Accomplishments

• 60.5% improvement for pressure ulcers
• 49.6% improvement for catheter-associated urinary tract infection (CAUTI)
• 20.2% improvement for Clostridioides difficile (C. diff) infection
• 5.4% improvement in hospital readmissions
• Improved teamwork and patient safety through Just Culture, TeamSTEPPS, and quality improvement training
• Co-created enduring resources to support appropriate opioid use and reduce the harm associated with inappropriate opioid use through coordination and collaboration with the IHS National Committee on Heroin Opioids and Pain Efforts (HOPE Committee)
• Increased organizational capacity and staff skills by providing guidance and coaching for quality improvement projects
• Increased organizational capacity and staff skills through guidance and coaching for quality improvement projects
• Fostered trusted relationships with facility leaders and community members

We make lives better by…

Improving health and health care for American Indians and Alaska Native people. During our work together, we have collaboratively improved health care quality by developing trusted relationships with healthcare facility staff and within communities.